General Information: WESTCHESTER CARE CENTER
Nursing home name WESTCHESTER CARE CENTER
Address6100 SOUTH RURAL ROAD
TEMPE, AZ 85283
Phone number (480) 831-8660
Located within a hospital No
Type of ownership Non profit - Church related
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityYes
Resident and family councils Resident
Certified number of beds 111
Total number of residents 69
Perc of occupied beds 62
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints12
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: WESTCHESTER CARE CENTER
Overall rating 2
2
Nursing Home Staffing 4
4
Registered Nurses only 4
4
Health Inspections 1
1
Quality Measures 4
4
Nursing Home Staffing Info: WESTCHESTER CARE CENTER
National AverageArizona AverageWESTCHESTER CARE CENTER
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 4
4
Total Number of Residents NA NA 69
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.56 hours 4.39 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.94 hours 1.86 hours
Registered Nurses Hours per Residents per Day 0.81 hours 1.03 hours 0.77 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.91 hours 1.09 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.62 hours 2.53 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.16 hours 0.08 hours
Health Survey: WESTCHESTER CARE CENTER
Heath Survey Summary on 2013-09-26
Total Number of Health Deficiencies 24
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Heath Survey Summary on 2012-07-27
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-06-06
Total Number of Health Deficiencies 5
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Health Survey Details: WESTCHESTER CARE CENTER
Inspection Results: 09/26/2013
Corrected Deficiency Scope and Severity
12/17/2013 Ensure that residents are fully informed and understand their health status, care and treatments. Isolated/Minimal harm or potential for actual harm
12/17/2013 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
12/17/2013 Allow residents to easily view the results of the nursing home's most recent inspection. Pattern/Potential for minimal harm
12/17/2013 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Pattern/Minimal harm or potential for actual harm
12/17/2013 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Pattern/Minimal harm or potential for actual harm
12/17/2013 Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Isolated/Actual harm
12/17/2013 Provide clean bed and bath linens that are in good condition. Pattern/Minimal harm or potential for actual harm
12/17/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
12/17/2013 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
12/17/2013 Ensure services provided by the nursing facility meet professional standards of quality. Pattern/Minimal harm or potential for actual harm
12/17/2013 Provide care by qualified persons according to each resident's written plan of care. Isolated/Minimal harm or potential for actual harm
12/17/2013 Make sure that residents receive treatments/services to maintain or improve their ability to care for themselves. Isolated/Minimal harm or potential for actual harm
12/17/2013 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Isolated/Minimal harm or potential for actual harm
12/17/2013 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Pattern/Minimal harm or potential for actual harm
12/17/2013 Train all employees on what to do in an emergency, and carry out unannounced staff drills. Pattern/Minimal harm or potential for actual harm
12/17/2013 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
12/17/2013 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
12/17/2013 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Pattern/Minimal harm or potential for actual harm
12/17/2013 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
12/17/2013 Make sure menus meet the resident's nutritional needs and that there is a prepared menu by which nutritious meals have been planned for the resident and followed. Pattern/Minimal harm or potential for actual harm
12/17/2013 Use a registered nurse at least 8 hours a day, 7 days a week. Isolated/Minimal harm or potential for actual harm
12/17/2013 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
12/17/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Actual harm
12/17/2013 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
Inspection Results: 07/27/2012
Corrected Deficiency Scope and Severity
09/04/2012 Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Pattern/Minimal harm or potential for actual harm
09/04/2012 Conduct initial and periodic assessments of each resident's functional capacity. Pattern/Minimal harm or potential for actual harm
09/04/2012 Allow residents the right to participate in the planning or revision of care and treatment. Isolated/Minimal harm or potential for actual harm
09/04/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
09/04/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
09/04/2012 Ensure that residents are safe from serious medication errors. Isolated/Minimal harm or potential for actual harm
09/04/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Pattern/Potential for minimal harm
09/04/2012 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Pattern/Minimal harm or potential for actual harm
Inspection Results: 06/06/2011
Corrected Deficiency Scope and Severity
07/05/2011 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Isolated/Minimal harm or potential for actual harm
07/05/2011 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated/Minimal harm or potential for actual harm
07/05/2011 Reasonably accommodate the needs and preferences of each resident. Isolated/Minimal harm or potential for actual harm
07/05/2011 Post nurse staffing information/data on a daily basis. Pattern/Potential for minimal harm
07/05/2011 Give or get quality laboratory services/tests in a timely manner to meet the needs of residents. Pattern/Potential for minimal harm

Fire Safety Survey: WESTCHESTER CARE CENTER
Fire Safety Survey Summary on 2013-09-25
Total Number of Fire SafetyDeficiencies 12
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-07-25
Total Number of Fire SafetyDeficiencies 9
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-06-07
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey: WESTCHESTER CARE CENTER
Fire Safety Survey Results: 09/25/2013
Corrected Deficiency Severity
11/15/2013 Corridors that are separated from use areas by walls constructed to limit the passage of smoke. Isolated/Minimal harm or potential for actual harm
11/15/2013 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
11/15/2013 Walls that prevent smoke from passing through and would resist fire for at least one hour. Isolated/Minimal harm or potential for actual harm
11/15/2013 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Widespread /Minimal harm or potential for actual harm
11/15/2013 Corridors or aisles that are unobstructed and are at least 8 feet in width. Widespread /Minimal harm or potential for actual harm
11/15/2013 Record of quarterly fire drills for each shift under varying conditions. Isolated/Minimal harm or potential for actual harm
11/15/2013 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
11/15/2013 Portable fire extinguishers. Isolated/Minimal harm or potential for actual harm
11/15/2013 Properly protected cooking facilities. Widespread /Minimal harm or potential for actual harm
11/15/2013 Proper medical gas storage and administration areas. Isolated/Minimal harm or potential for actual harm
11/15/2013 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm
11/15/2013 Properly installed electrical wiring and equipment. Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Results: 07/25/2012
Corrected Deficiency Severity
08/31/2012 Smoke barrier doors that can resist smoke for at least 20 minutes. Pattern/Minimal harm or potential for actual harm
08/31/2012 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
08/31/2012 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Widespread /Minimal harm or potential for actual harm
08/31/2012 Corridors or aisles that are unobstructed and are at least 8 feet in width. Pattern/Minimal harm or potential for actual harm
08/31/2012 Emergency lighting that can last at least 1 1/2 hours. Widespread/Potential for minimal harm
08/31/2012 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
08/31/2012 Proper medical gas storage and administration areas. Widespread /Minimal harm or potential for actual harm
08/31/2012 Properly installed electrical wiring and equipment. Widespread /Minimal harm or potential for actual harm
08/31/2012 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Results: 06/07/2011
Corrected Deficiency Severity
07/14/2011 Corridors that are separated from use areas by walls constructed to limit the passage of smoke. Isolated/Minimal harm or potential for actual harm
07/14/2011 Walls that prevent smoke from passing through and would resist fire for at least one hour. Isolated/Minimal harm or potential for actual harm
07/14/2011 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Pattern/Minimal harm or potential for actual harm
07/14/2011 Properly protected cooking facilities. Isolated/Minimal harm or potential for actual harm
07/14/2011 Exits that are free from obstructions and can be used at all times. Pattern/Minimal harm or potential for actual harm

Resident Complaints: WESTCHESTER CARE CENTER
Date Complaint Substantiated: 11/30/2011
CorrectedCategoryDeficiencySeverity
01/30/2012Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. G

Quality Measures: WESTCHESTER CARE CENTER
Quality Measures National Average Arizona Average WESTCHESTER CARE CENTER
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 15.3% 19.1%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 10.7% 3.8%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.1% 5.4%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.7% 5.7%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 51.5% 64.8%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 4.5% 0.5%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 6.2% 5.1%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 4.0% 0.6%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 0.7% 15.1%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 2.7% 0.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 95.0% 77.1%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.9% 96.1%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 20.3% 12.6%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 23.7% 24.9%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.7% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 89.9% 67.4%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 88.9% 82.6%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 4.0%

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